Montana enforces Medicaid work rules on patients its own exemption was written to excuse.

…(cont) Nine days before Montana flips the switch, on September 22nd, a lawsuit landed saying the part never got installed. Medicaid enrollees, several major health care advocacy organizations, and the city of Columbus, Ohio, told a court the administration's final rule narrows who counts as medically frail so tightly that it isn't what Congress wrote — the exemption sitting on paper while the enforcement runs anyway.

The next day, September 23rd, a new campaign launched to help millions figure out how to keep coverage once the rules take effect nationwide on January 1st — what NBC News called the most substantial change to Medicaid in decades. Ninety-three days stand between today and that date. Every state runs Montana's experiment then, confusion and all, unless the exemption gets built before the deadline does.

The crew's read on the assembly: the chief doesn't send anyone chasing a new statute, because there isn't one to chase — the fix is the part already bolted to the frame, the exemption Congress wrote sitting unused in the rule. The planner traces the schematic: narrow the definition on paper, and the part looks installed without ever doing the job. The tinkerer pulls the actual rule language and finds the gap between "medically frail" as Congress wrote it and medically frail as the agency defined it — that gap is the whole lawsuit. The muscle doesn't touch the work requirement itself; the muscle goes after the rule that shrank the exemption, because that's the load-bearing wall doing the damage. The pilot's job is simpler than it sounds: fly the exemption Congress already authorized to the people Montana is calling this week, before January 1st turns the rest of the country into the same phone bank.

No new statute. No new agency. Just the part already sitting on the shelf, waiting for somebody to bolt it on.